Manual Evacuation of Faeces

Manual evacuation of faeces involves the use of a single gloved and lubricated finger to remove faeces from the rectum. It is used by individuals with both hyperreflexic and areflexic bowel dysfunction. Coggrave et al. (2009) (n=1334) reported that manual evacuation of faeces for people with SCI was found to be the most commonly used intervention, carried out by 56% of respondents. A systematic review (Solomons & Woodward 2013) found that digital stimulation and digital removal of faeces were associated with the lowest rates of unplanned bowel evacuations and less time spent on bowel care (Haas et al. 2005) and concluded that digital removal of faeces is a necessary component of bowel care for many individuals with SCI.

Conclusion

Manual evacuation is a key method in conservative bowel management practice and is commonly and widely employed. It reduces number of unplanned bowel evacuations. There is conflicting evidence on the effect of manual evacuation on duration of bowel evacuation.

Digital evacuation of stool is a very common intervention for bowel management after SCI, reducing duration of bowel management and fecal incontinence.